Castillo O A, Travassos J, Escobar J F, Lopez-Fontana G
Unidad de Urología y Centro de Cirugía Robótica, Clínica Indisa, Santiago, Chile; Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile.
Actas Urol Esp. 2013 Nov-Dec;37(10):658-62. doi: 10.1016/j.acuro.2012.11.017. Epub 2013 Aug 1.
The Boari flap is an excellent technique for replacement of distal ureteral injuries. There are few reports with the use of laparoscopic surgery, especially with long term results. Our goal is to present the results of a multi-institutional study of 30 cases.
We analyzed 30 patients treated between December 2001 and January 2009 who underwent a laparoscopic intracorporeal Boari flap, in three Latin American centers. In all cases the same surgical technique was employed. The database was recorded prospectively and analyzed retrospectively.
The mean age was 43.2 years (range 9 to 71 years). Most were women (22 of 30) with a slight predominance of left-side lesions (17 of 30). The most common cause of ureteral injury was hysterectomy in 14 patients (46.6%) and endoscopic ureterolithotomy in 9 patients (30%). The mean length of ureteral resection was 7 cm. (5 to 20 cm). The average operative time was 161.16 min (90 to 280 min). The average estimated blood loss was 123 mL. (0 to 500 mL), and hospital stay was 4.86 days (2 to 10 days). There were no intraoperative complications or conversion to open surgery. Postoperative complications occurred in 5 patients (16.6%), Clavien 1 in 2 patients (6.6%) and Clavien 3 in three patients (10%). The success rate was 96.6% (29 patients) with a mean follow up of 32 months (5 to 60 months).
Laparoscopic Boari flap in our hands had good short and long term results.
博阿里皮瓣是一种用于替代远端输尿管损伤的优秀技术。使用腹腔镜手术的报道较少，尤其是长期结果。我们的目标是展示一项针对30例病例的多机构研究结果。
我们分析了2001年12月至2009年1月期间在三个拉丁美洲中心接受腹腔镜体内博阿里皮瓣手术的30例患者。所有病例均采用相同的手术技术。数据库进行了前瞻性记录并进行回顾性分析。
平均年龄为43.2岁（范围9至71岁）。大多数为女性（30例中的22例），左侧病变略占优势（30例中的17例）。输尿管损伤的最常见原因是子宫切除术，共14例患者（46.6%），内镜输尿管取石术9例患者（30%）。输尿管切除的平均长度为7厘米（5至20厘米）。平均手术时间为161.16分钟（90至280分钟）。平均估计失血量为123毫升（0至500毫升），住院时间为4.86天（2至10天）。无术中并发症或转为开放手术的情况。5例患者（16.6%）发生术后并发症，2例患者（6.6%）为Clavien 1级，3例患者（10%）为Clavien 3级。成功率为96.6%（29例患者），平均随访32个月（5至60个月）。
在我们手中，腹腔镜博阿里皮瓣手术取得了良好的短期和长期效果。
